Klingebiel T, Pession A, Paolucci P, Rondelli R
Childrenïs Hospital of the University, Tubingen, FRG.
Bone Marrow Transplant. 1996 Nov;18 Suppl 2:49-52.
The Austrian-German-Italian (AGI) Pediatric Bone Marrow Transplantation Registry includes now data of 520 patients grafted for acute myeloid leukemia (AML) by autologous and allogeneic stem cells. In first complete remission (CR1) 145 patients with allografts had a possibility of event free survival (pEFS) of 0.57 and 140 patients with autografts a pEFS of 0.46. In second complete remission (CR2) autografted patients (n = 70) had a pEFS of 0.36 and allogeneic patients (n = 41) of 0.34. Patients with no CR went worse (allogeneic pEFS 0.15 n = 37; autologous pEFS 0.17 n = 6). Therefore, from the European data the following conclusions can be drawn: neither in CR1 nor in CR2 any statistical advantage for a particular transplantation type can be found. To assess the value of transplantation with family mismatch donors or matched unrelated donors (MUD) basing on these data pool is not possible. The following decisions should be reached: 1) BMT for AML with mismatched or unrelated donors should be done only within cooperative European trials. 2) Generally accepted definitions of indications for BMT in AML are needed. 3) Study protocols concerning conditioning are necessary.
奥地利 - 德国 - 意大利（AGI）儿科骨髓移植登记处目前收录了520例通过自体和异基因干细胞移植治疗急性髓系白血病（AML）患者的数据。在首次完全缓解（CR1）期，145例接受异基因移植的患者无事件生存期（pEFS）概率为0.57，140例接受自体移植的患者pEFS概率为0.46。在第二次完全缓解（CR2）期，自体移植患者（n = 70）的pEFS为0.36，异基因移植患者（n = 41）为0.34。未达到完全缓解的患者情况更差（异基因移植pEFS 0.15，n = 37；自体移植pEFS 0.17，n = 6）。因此，从欧洲的数据可以得出以下结论：无论是在CR1期还是CR2期，均未发现特定移植类型具有任何统计学优势。基于这些数据池评估与家族错配供体或匹配无关供体（MUD）进行移植的价值是不可能的。应达成以下决策：1）AML采用错配或无关供体的骨髓移植（BMT）仅应在欧洲合作试验中进行。2）需要AML中BMT适应症的公认定义。3）有关预处理的研究方案是必要的。
